The transversus abdominis muscle has a unique function that works independently from the other abdominal muscles. This muscle contributes to                a) the control of the lumbar spine and pelvic girdle and        b) the ability to generate stiffness in a non-specific direction of the lumbar spine and pelvic girdle.        
Normally, the transversus abdominis muscle contracts before the other abdominal muscles and before movement occurs. This muscle contracts along with the multifidus muscle in order to prepare the spine and pelvic girdle for the impending movement and to prevent excessive translation or shear from occurring between the joints of the low back and pelvic girdle.
Intersegmental lumbar stability and stability of the pelvic girdle is enhanced by increasing the stiffness of the intersegmental and sacroiliac joints/pubic symphysis. The multifidus and transversus abdominis muscles attach directly to the spine and have been shown to create more than two-thirds of the increase in stiffness at the L4-5 (lumbar) segment for most individuals. The multifidus muscle attaches directly to the sacrum and the transversus abdominis muscle indirectly crosses the pelvic girdle (sacroiliac joints) through the thoracodorsal fascia. The co-activation of transversus abdominis and multifidus muscle have recently been shown to increase the stiffness of the sacroiliac joints of the pelvic girdle through these anatomical attachments. In this manner, shear forces through the spine and sacroiliac joints may be controlled and load transferred through the trunk and pelvic girdle to the lower extremities. Instability of the spine and/or pelvic girdle occurs when local muscles such as the multifidus and transversus abdominis are dysfunctional.
Stabilization of the pelvic girdle and lumbar spinal region requires compression of the sacroiliac joints and pubic symphysis by the activation of the deep abdominal muscles (transversus abdominis), the deep back muscles (multifidus) and the pelvic floor muscles. Many patients having lower back or pelvic pain often have a dysfunction of these muscles. These dysfunctions are typically of several varieties. One such dysfunction is a significant delay in the contraction of the transversus abdominis and/or multifidus muscles. When this contraction is delayed there is a failure to prepare the spine/pelvic girdle for the movement of the prime mover. Loss of independent control or consistent control of natural or high speed movements are also dysfunctions of these muscles. Treatment requires specific exercise instruction for retraining of proper muscle function. This includes restoring the appropriate recruitment patterning or timing of muscle contraction, muscle strength and endurance. Upon retraining of these muscles, lower back or pelvic pain is often alleviated.
During the muscular retraining process the patient may yet be in pain due to the dysfunction of these muscles, and the relative instability of the pelvic girdle. It has been found that one of the major causes of this type of back and sacroiliac pain is lack of motion control due to insufficient stiffness of the sacroiliac joints. In this condition, too little compression is generated within the pelvic girdle by the local muscles to control the vertical and anteroposterior shear forces which occur during activities of daily living such as walking, sitting and/or bending. This excessive translation leads to irritation of the local soft tissues and perpetuates the pain. The presence of pain has been shown to inhibit these local stabilizing muscles (transverses abdominis and multifidus). Thus, an outside compressive force as exerted by the instant invention is needed to increase the intrapelvic stiffness, assist in the control of shear forces and thus reduce the local pain. The instant invention therefore facilitates the training of the local stabilizers ultimately expediating recovery.
Many orthopedic belts have been used to attempt to protect against back injury and pain. However, these belts are generally worn in a position which is too high relative to an individual's back to be effective for relieving pelvic pain. The majority of these are back braces used for support of the lumbar region of the spine.
Frequently, it is necessary for compression to be applied to the pelvic girdle. The inventive belt described herein is typically positioned around the pelvic girdle of an individual between the greater trochanters of the femurs and the iliac crest of the innominate bones. The instant invention provides the necessary compressive force to the sacroiliac joint/pubic symphysis and provides an adjustable amount of force in a variety of specific locations, thereby allowing a practitioner to customize the belt for the specific needs of the patient. The belt provides minimal fitting requirements as it is adjustable and may accommodate the varied pelvic sizes of individuals.
Without limiting the scope of the invention a brief description of some of the claimed embodiments of the invention are set forth below. Additional details of the disclosed embodiments of the invention and/or additional embodiments of the invention may be found in the Detailed Description of the Invention below.
A brief abstract of the technical disclosure in the specification is provided as well only for the purposes of complying with 37 C.F.R. 1.72. The abstract is not intended to be used for interpreting the scope of the claims.